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比较有重大抑郁障碍的患者中家族性和非家族性自杀行为:检验高产量临床变量的区分预测作用。

Comparison of familial and non-familial suicidal behaviors among people with major depressive disorder: Testing the discriminative predicting role of high-yield clinical variables.

机构信息

New York State Psychiatric Institute, Columbia University, NY, USA.

出版信息

J Psychiatr Res. 2018 Jul;102:118-122. doi: 10.1016/j.jpsychires.2018.02.021. Epub 2018 Feb 23.

Abstract

BACKGROUND

Suicidal behavior in first-degree relatives of people diagnosed with major depressive disorder (MDD) increases the risk of suicidal behavior. Such an effect may be the result of genetic risk factors or environmental ones, including imitation, or both. Surprisingly few studies have examined this question and thus, there still is little known about the effect of first-degree family history of suicidal behavior on the type of suicidal behavior and profile of risk factors related to the diathesis for suicidal behavior. Even less is known about intra-familial risk transmission.

METHODS

Patients with MDD (n = 252) experiencing a current major depressive episode and who had a previous suicide attempt were studied. Those with and without a family history of first-degree relatives who had made a suicide attempt or died by suicide were compared across clinical and suicide-related characteristics.

RESULTS

Suicide attempters with (FDR, n = 59) and without a first-degree relative with suicide attempt or suicide (FDR, n = 193) were similar in terms of type or frequency of suicide attempts, level of lifetime aggression and impulsivity, age of onset of depression and age at first suicide attempt.

LIMITATIONS

Cross-Sectional study. Lack of additional external validators.

CONCLUSIONS

Contrary to our hypothesis and the concept of "genetic anticipation", a first-degree family history of suicide attempt or suicide in currently depressed attempters with MDD was not associated with a range of clinical and suicide-related characteristics. Longitudinal studies incorporating external validators and potential biological markers may advance this area of research.

摘要

背景

被诊断患有重度抑郁症(MDD)的患者的一级亲属的自杀行为会增加自杀行为的风险。这种影响可能是遗传风险因素或环境因素的结果,包括模仿,或者两者兼而有之。令人惊讶的是,很少有研究检查过这个问题,因此,我们对一级亲属自杀行为史对自杀行为类型和与自杀行为素质相关的风险因素特征的影响知之甚少。关于家族内风险传递的了解就更少了。

方法

研究了 252 名患有 MDD 的患者(当前经历重度抑郁发作,且之前有过自杀未遂史)。比较了有和没有一级亲属自杀未遂或自杀死亡家族史的患者在临床和自杀相关特征方面的差异。

结果

有(FDR,n=59)和没有(FDR,n=193)一级亲属自杀未遂或自杀史的自杀未遂者在自杀类型或频率、一生中的攻击性和冲动性水平、抑郁发作的年龄和首次自杀尝试的年龄方面相似。

局限性

横断面研究。缺乏额外的外部验证器。

结论

与我们的假设和“遗传预期”概念相反,在当前患有 MDD 的抑郁未遂者中,一级亲属有自杀未遂或自杀史与一系列临床和自杀相关特征无关。纳入外部验证器和潜在生物学标志物的纵向研究可能会推进这一研究领域。

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